Supreme Physical Therapy and Wellness Rehabilitation Center
NPI 1376301614ActiveOrganization· Physical Therapist· Stratford, CT
Physical Therapist in Stratford, Connecticut, registered in NPPES in March 2024. The authorized official on file is Ilicia Mathis, DPT, Co- Owner.
Overview
| NPI | 1376301614 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 11, 2024 |
| Last updated in NPPES | Mar 11, 2024 |
| Certified by provider | Mar 11, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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